Breastfeeding: the Struggle Is Real

My Little Dude is almost 9 months old. Which means it has also been almost 9 months since that day in the hospital when he was snatched from my arms AS I WAS TRYING TO NURSE HIM (my perception at the time; keep in mind I was medicated and running on fumes). The doctor was rounding and needed to evaluate him and do a weight check, and apparently it couldn’t wait.

I remember the doctor saying “He lost too much weight. You need to give him formula. Now.” The next several hours were a blur. As I cried hysterically, my poor husband had to feed Little Dude his first bottle of formula. I wanted nothing to do with any of it.

Given my reaction, you may or may not believe me when I say I have nothing against formula, but it’s true. Formula is a good nutritional supplement and, for some mothers, the best way for them to feed their babies. However, there is a big difference between a woman who chooses formula because she has made the informed choice that it is best for her family, and a woman who resorts to formula when her hopes for being able to nurse start slipping away. While I have nothing against formula, I have everything against a system that offers formula as the first, best alternative the minute breastfeeding becomes a struggle.

Breastfeeding, as natural as it is, is NOT easy. I don’t think we stress that enough. And I don’t think we provide enough support for women who want it.

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Again, I have nothing against medically necessary formula supplementation. Although my memory is foggy, I trust that the doctor who invaded my hospital room that morning was probably right. If Little Dude had lost too much of his body weight, then he needed that bottle of formula. My husband, who was operating on slightly more sleep and less medication, confirms that Little Dude’s weight had dipped quite a bit. What I am still struggling to get over is the way the situation was handled.

I wish someone had sat down with me after the doctor left – a nurse or lactation consultant, perhaps – and broken the news to me in a less reactionary fashion. Little Dude would not have starved in the five minutes or less it would have taken for someone to calmly explain the situation, the need for an immediate intervention, and my options going forward before they tipped me over the hormonal edge I was balancing on. I wish I had been given more guidance or reinforcement on ways to encourage my milk to come in and maintain my supply while we supplemented. I had to request a pump, and when the nurse brought it she gave me the briefest explanation of how and when to use it. I had taken a class, but lack of sleep and complete overwhelm won out over the careful notes I had taken (I found them about a week ago – no joke).

By the time we were released from the hospital, I was always one feeding away from saying, “Well, he’s eating the formula and he’s happy. This isn’t working out. Why bother?” However, several decades’ worth of stubbornness prevailed, along with just the right amount of awe at how beautiful it could be when Little Dude actually managed a decent latch. If only tenacity alone could build a successful breastfeeding relationship.

I had taken a class and listened to some podcasts. My favorite is All About Breastfeeding – Lori does an amazing job, and through her show I learned enough to know that pain is not normal; it meant I needed help. I received immediate help from a friend who came over, watched me nurse, and offered guidance. I will always be grateful for her for knowing just what to do to tide us over until we could find the right professional help.

I knew the best source of help would come from a lactation consultant (paired with our very understanding and supportive pediatrician, who even suggested ways to increase my supply). The first lactation consultant we saw worked with our network of doctors. From what I can recall, she was a nurse practitioner who had also trained in lactation. Little Dude behaved and latched perfectly during the session (really, Dude!?), which lasted half an hour. We were encouraged to keep trying. I’ve since learned that half an hour likely isn’t enough time to diagnose most feeding issues.

We continued to struggle.

A friend of mine suggested I see an IBCLC. For those unfamiliar with the difference, IBCLC stands for International Board Certified Lactation Consultant (aka, someone who has put in the intensive studying, testing, and clinical hours to earn the right to put those letters after her name). If all you need is a little guidance or reassurance, friends who have been there and lactation consultants (who have gone through more basic training) might be enough. But when more complex issues affecting supply and/or latch are involved, your best bet is an IBCLC. They’re often times not covered by insurance (although technically, the Affordable Care Act legally obligates most insurance companies to reimburse you if they cannot provide a list of in-network consultants), but the out of pocket fee (if breastfeeding is a priority) is worth every penny.

The IBCLC consult lasted over an hour. She weighed Little Dude, watched a full feeding, weighed him again, asked me all sorts of questions, and gave him a full oral motor assessment. She recommended we see an oral motor therapist. It turns out Little Dude wasn’t using his mouth and jaw muscles effectively.

Finding a root cause for all of our issues provided a sense of relief. Finally, we could start getting to the bottom of things and nurturing a more successful breastfeeding relationship. We had a pumping routine (which I struggled to stick to) to rescue my supply, and we had exercises to strengthen his muscles. But Christmas arrived before we got it right – over two months after Little Dude’s birth. By that time, the damage was done. My supply never entirely bounced back without a full regimen of supplements (Moringa, Motherlove More Milk Plus, Sunflower Lecithin), oats, brewer’s yeast, and effort. Little Dude had one glorious week of drinking exclusively from the tap. Beyond that, he was always frustrated and needed a bottle after nursing.

We eventually switched to Exclusively Pumping. I didn’t even know that was a thing before it happened to me. Initially, I felt like a “failure” because we were no longer nursing. Now, I feel like a champion for providing some milk for my Little Dude for 9 months. My original goal was to directly nurse for a year and then contemplate when and how to wean. However, plans change, and I feel like I’ve done the best I can with the hand I was dealt. And I learned so much. I still get angry sometimes at what I had to do to unearth the information that I did. It should have been easier. It should not have taken us as long as it did, and the effort that it did, to get the help that we needed. Because with feeding, time is critical. You need to diligently work on your supply from day one, nursing or pumping, or you’ll always be struggling to play catch-up like me.

If I ever get pregnant again, knowing how much I struggled, I will be working with an IBCLC from before I deliver. Along with pre-registering at the hospital, I will have a pre-consult with my IBCLC to discuss my hopes and fears, and to come up with a game plan for all scenarios. With luck, I’ll get to see her before I even leave the hospital.

If breastfeeding is a priority for you, having a game plan is essential. Contact a lactation consultant, IBCLC, or local La Leche League before you even deliver. Talk to friends who breastfed. Compile a list of resources and tips. Read up, but don’t expect that to take the place of hands-on advice. Learn as much as you can, and then pass that knowledge along to the next woman.

And if you choose formula, I hope it is a choice and not a prematurely forced option. You are entitled to the support you need for the choice you make, as far as that support will take you.